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General NPI Number Information
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NPI Number | 1376848630
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Entity Type | Individual
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Provider Name | JOANNE KAY DILLEY LMP
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Gender | Female
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Dates
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Enumeration Date | 01/18/2011
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Last Update Date | 06/04/2012
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Provider Practice Location Address
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Address Line | 401 OLYMPIA AVE NE SUITE 316
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City | RENTON
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State | WA
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Zip | 98056-4117
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Country | US
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Telephone | 206-595-5507
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Fax |
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Provider Business Mailing Address
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Address Line | 3630 S 268TH ST
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City | KENT
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State | WA
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Zip | 98032-7035
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Country | US
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Telephone | 206-595-5507
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Fax | 206-772-2073
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA 60188177
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License Number State | WA
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